Chapter 7 Practice (Leadership) Improving and Managing Safe and Qualit

Care
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The nurse administrator is aware that the 1984 death of a college
student from a drug-drug interaction resulted in what standard of
medical care?

1)Computerized prescribing
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2)Time out required before beginning any surgery

3)Limitation to the number of hours a resident in training may work

4)Access to a rapid response team

The nurse manager of surgical operations knows that the Uni-
versal Protocol for Preventing Wrong Site,Wrong Procedure,and
Wrong Person Surgery does not include which component?

1)A time out called immediately before surgery begins to ensure

that all elements of the surgery are correct.

2)Two surgeons must confirm immediately prior to the surgery that 2

the patient is receiving the correct procedure.

3)The surgeon must mark and sign the site of surgery immediately
prior to the surgery while the patient is still awake.

4)The patient's identification must be verified with at least two

identifiers.
The nurse leader is observing a new graduate registered nurse
and knows that which error would be considered an error of
commission?

1)The nurse contaminated the IV Cathlon by touching the skin but

continued the procedure and inserted it into the patient's forearm.

2)The nurse was taking care of a patient who went to radiology for
an x-ray.Upon the patient's return,the nurse forgot to administer
1
the patient's medications.

3)The nurse is caring for a patient who is scheduled to be am-

bulated three times a day and neglects to walk the patient at all
during the shift.

4)The nurse received an order to change the patient's diet from

clear liquid to NPO and forgot to enter the change.The patient ate
a liquid meal and surgery had to be delayed until the next morning.
The nurse manager is aware that which incident would be classi-
fied as a sentinel event?

1)The patient receives an oral antidiabetic medication 6 hours

after it should have been administered.His blood sugar is slightly
elevated,but it returns to its normal range within 1 hour.

2)The patient receives a second-degree burn from a malfunction

in a hypothermia blanket. 2

3)The patient got dizzy and sat down on the floor approximately
1 hour after the administration of an antihypertensive medica-
tion.The patient did not experience any injury.

4)The patient is using a continuous passive exercise machine

after knee surgery when the machine quits working.The patient
complains of pain when the knee is removed from the ma-
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 Chapter 7 Practice (Leadership) Improving and Managing Safe and Qualit
Care
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chine.The pain is relieved after the administration of pain med-
ication.
The nurse manager is discussing an error that occurred with a
nurse and is using the person approach to human error if the
manager makes which statement?

1)"How many patients were you caring for when this error oc-
curred?"
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2)"What was the acuity level of the patients that you were caring
for?"

3)"What else was happening on the unit when the error occurred?

4)"Didn't you learn to do this procedure in school?"

The nurse manager is conducting an investigation into a series of
patient falls that have occurred on the nursing unit in the past 3
weeks.While investigating the issue,the nurse manager identified
a number of factors that may have influenced the problem and
knows that which one would be classified as a human factor?

1)The unit does not have an adequate number of gait belts avail-
2
able to the staff.

2)Two unit staff members have been on extended sick leave.

3)Bedside rounding has been sporadic.

4)The charge nurse is new to the position.

The nurse manager is working to establish a culture of safety
and knows that which element is the most important factor to its
establishment?

1)No punishment is involved for reporting.

1
2)Policies are easily accessible.

3)All policies are communicated to all staff.

4)The policy is begun on all units at the same time.

The nurse manager knows that what is the most important focus
of a culture of safety?

1)Improving efficiency of patient care

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2)Increasing training of staff regarding basic elements of safety

3)Looking at the reason for an error

4)Praising staff when no errors are committed

The nurse leader is aware that which change in unit policy will
have the most impact in creating a culture of safety on the unit?

1)Establishing a patient admission checklist to ensure that all

important information related to safety is communicated to the
4
patient

2)Conducting bedside rounds for nurse-to-nurse end-of-shift

handoff

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 Chapter 7 Practice (Leadership) Improving and Managing Safe and Qualit
Care
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3)Encouraging discussion of errors between staff members

4)Working with staff to improve memory skills to improve docu-

mentation
The nurse leader plans to use the Patient Safety Network
(PSNet)Web site for information to assist in improving patient
safety on the nursing unit and knows that which information is not
one of the resources found at this site?

1)The resources focus on patient safety that relates to both med-

ical professionals and laypersons.
4
2)All of the resources found on the Web site provide insight into
patient safety.

3)All of the resources are from experts in the field of safety.

4)Nurses have written all of the material found on the Web site.
The nurse leader is referencing the American Nurses Associa-
tion's nursing-sensitive quality indicators and knows that structure
indicators include which element?

1)Job satisfaction
3
2)Changes in patient health-care status

3)Hours of nursing care per patient

4)Deliverance of nursing care

The nurse leader references the National Quality Forum (NQF)for
information about patient safety and is aware that which statement
is not a goal of this forum?

1)Reduction of preventable hospital admissions and readmis-

sions
4
2)Advancement of electronic measurement to capture necessary
data for performance measurement

3)Reduction of the incidence of adverse health care-associated

conditions

4)Reduction in harm from inappropriate or unnecessary care

The nurse leader is beginning to create a culture of safety on the
nursing unit and is aware that which tasks must be accomplished
in Stage 3 of this process? Select all that apply.

1)Safety is an external requirement imposed by regulatory bodies.

2)Safety performance is viewed as dynamic and in need of con-

2, 3, 5
tinuous improvement.

3)Strong emphasis is placed on improving efficiency.

4)Safety performance is expressed in terms of goals.

5)Communication and training are important features.

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